Healthcare Provider Details

I. General information

NPI: 1396287710
Provider Name (Legal Business Name): MEGAN CATHLEEN LEMON FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2016
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 MDG/SGXF 101 BODIN CIRCLE
TRAVIS AFB CA
94535-1809
US

IV. Provider business mailing address

60 MDG/SGXF 101 BODIN CIRCLE
TRAVIS AFB CA
94535-1809
US

V. Phone/Fax

Practice location:
  • Phone: 707-423-7295
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP95005430
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number803816
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: